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Asthma affects the lower respiratory tract (bronchi), whereas chronic rhinosinusitis with nasal polyposis (CRSwNP) involves the upper airways. Despite this anatomical distinction, the upper and lower airways form a continuous respiratory tract and share common pathophysiological mechanisms. Consequently, asthma and CRSwNP frequently coexist, and several therapeutic strategies are effective for both conditions.
Given these overlaps, we hypothesize that a multidisciplinary consultation involving both a pulmonologist and an ENT specialist could be more effective than separate consultations for patient care. We also believe that this innovative organization that would benefit the healthcare system.
To test this hypothesis, we are conducting a study whose primary objective is to assess whether joint consultations lead to a reduction in oral corticosteroid need over the year following the initial consultation, by enabling more personalized treatment strategies.
Secondary outcomes will include the frequency of asthma exacerbations, frequency of ENT-related events, respiratory symptoms, quality of life, and healthcare ressources utilization.
We will compare outcomes between two patient groups: one receiving joint consultation from both specialists, and the other managed through standard, separate consultations as per current clinical practice.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Joint consultation | Experimental | Multi-disciplinary consultation with a pulmonologist and ENT specialist at the baseline visit |
|
| Separate consultations | Active Comparator | Separate consultations with a pulmonologist and ENT specialist at the baseline visit as standard care |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Joint consultation | Other | Joint consultation with pneumologist and ENT at baseline. |
| |
| Measure | Description | Time Frame |
|---|---|---|
| Effectiveness of joint ENT and pulmonologist consultation on relative change in cumulative annual dose of oral corticosteroids from the year before Baseline to the year between Baseline and 12 months visit. | Self reported cumulative annual dose of oral corticosteroids. | From the year before Baseline to the 12 months visit. |
| Measure | Description | Time Frame |
|---|---|---|
| Reduction of asthma exacerbations frequency. Relative change from the year before Baseline to the year between baseline and 12 months visit in number of asthma exacerbations. | self-reported number of asthma exacerbations | From the year before Baseline to the 12 months visit. |
| Reduction of ENT events frequency. Relative change from the year before baseline to the year between baseline and 12 month visit in number of ENT events. |
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Inclusion Criteria:
Exclusion Criteria:
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Model Description
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Masking Description
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| Mucus sampling |
| Procedure |
Mucus sampling at baseline and one year follow-up |
|
| Nasal brushing | Procedure | Nasal brushing at baseline and one year follow-up |
|
Self reported number of ENT events |
| From the year before Baseline to the 12 months visit. |
| Improvement of asthma control. Relative change from baseline to 12 months visit in ACQ-6 score | Self-administered questionnaire | Baseline and 12 months visit. |
| Improvement of chronic rhinosinusitis with nasal polyposis control . Relative change from baseline to 12 months visit in SNOT-22 score | Self-administered questionnaire | Baseline and 12 months visit. |
| Reduction in endoscopic polyp score. Relative change from baseline to 12 months visit in the polyp endoscopic score (mean of measures of both nostrils) | Evaluated with nasal endoscopy | Baseline and 12 months visit. |
| Improvement of patient's quality of life. Relative change from baseline to 12 months visit in EQ-5D-5L score | Self-administered questionnaire | Baseline and 12 months visit. |
| Reduction of healthcare ressource use . Relative change from baseline to 12 months visit in number of consultations with a specialist, general practitionner, emergency visits and hospitalizations | Self-reported number of consultations with a specialist, general practicionner, emergency visits and hospitalizations | From Baseline to the 12 months visit |
| ID | Term |
|---|---|
| D001249 | Asthma |
| ID | Term |
|---|---|
| D001982 | Bronchial Diseases |
| D012140 | Respiratory Tract Diseases |
| D008173 | Lung Diseases, Obstructive |
| D008171 | Lung Diseases |
| D012130 | Respiratory Hypersensitivity |
| D006969 | Hypersensitivity, Immediate |
| D006967 | Hypersensitivity |
| D007154 | Immune System Diseases |
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